NEBIVOLOL AND METOPROLOL: LONG - TERM EFFECT ON OXIDATIVE STRESS: PP.2.55

Abstract

Objective: Hypertension is associated with increased oxidative stress, which may have an impact on further cardiovascular risk. There are only a few and controversial data on the effect of beta-blockers on oxidative stress. The aim of the present study was to evaluate the effects of nebivolol (NEB) and metoprolol (MET) succinate on oxidative stress in hypertension. Design and Method: In a double-blind study 80 mild to moderate essential hypertension patients (mean age 47 ± 10 years; 41 male, 39 female) were randomized to receive either MET succinate 50–100 mg or NEB 5 mg once daily for 1 year. Peripheral blood pressure (BP), plasma oxidized low- density lipoprotein (oxLDL), total cholesterol, LDL-cholesterol, HDL-cholesterol, glucose, urine excretion of 8-iso PGF-2α adjusted to urine creatinine were measured at baseline and after 1 year of treatment. Results: Baseline BP, total cholesterol, LDL-cholesterol, HDL-cholesterol, oxLDL, glucose and 8-iso PGF 2α did not differ for the two treatment groups. NEB and MET reduced equally significantly peripheral systolic and diastolic BP. Total cholesterol, LDL-cholesterol, HDL-cholesterol and glucose did not change in either treatment group. OxLDL was reduced significantly in the NEB and MET groups (from 85.5 to 62.0 U/L; p < 0.01 and from 88.6 to 65.5 U/L; p = 0.0001, respectively). Moreover, NEB reduced 8-iso PGF-2α significantly (from 43.0 to 21.8 ng/mmol creatinine; p = 0.01), while metoprolol had no effect on 8-iso PGF-2α (from 43.2 to 34.4ng/mmol creatinine; p = 0.37). The changes in oxLDL and 8-iso PGF-2α were independent of the effects of the drugs on BP. Conclusion: NEB and MET reduced significantly proatherogenic oxLDL level, however, NEB decreased systemic oxidative stress marker 8-iso PGF-2α. These findings grant an additive value to long-term use of NEB in treatment of hypertension.